Susceptibility to tobacco use and associated factors among youth in five central and eastern European countries.

BACKGROUND: Tobacco use among young people still remains a major public health problem. Thus, the aim of this study was to perform a cross-country comparison for the factors associated with susceptibility to tobacco use among youth from five central and eastern European countries. METHODS: The data used in the current analysis, focusing on youth (aged 11-17 years), who have never tried or experimented with cigarette smoking, was available from the recent Global Youth Tobacco Survey (Czech Republic (2016), n = 1997; Slovakia (2016), n = 1998; Slovenia (2017), n = 1765; Romania (2017), n = 3718; Lithuania (2018), n = 1305). Simple, multiple logistic regression analyses and random-effect meta-analysis were conducted to identify factors associated with tobacco use susceptibility as the lack of a firm commitment not to smoke. RESULTS: Nearly a quarter of the students were susceptible to tobacco use in 4 of 5 countries. The following factors were identified, consistently across countries, as correlates of tobacco use susceptibility: exposure to passive smoking in public places (AOR from 1.3; p = 0.05 in Slovakia to 1.6; p < 0.01 in Czech Republic and Romania), peers smoking status (AOR from 1.8 p < 0.01 in Slovakia to 2.5; p < 0.01 Lithuania), opinion that smoking helped people feel more comfortable at celebrations (AOR from 1.3; p = 0.01 in Czech Republic to 1.9; p < 0.01 in Lithuania), noticing people using tobacco in mass media (AOR 1.5; p < 0.01 in Slovenia and 1.6; p < 0.01 in Lithuania), lack of knowledge on harmful effects of passive smoking (AOR 1.8; p < 0.01 in Slovakia and 2.4; p < 0.01 in Slovenia), lack of antismoking education provided by school (AOR 1.3; p < 0.05 in Czech Republic, Slovakia and Slovenia; 1.9; p < 0.01 in Lithuania), and family (AOR 1.5; p < 0.01 in Slovenia and Romania). Moreover those who believed that smoking makes young people look less attractive (AOR from 0.5; p < 0.01 in Romania to 0.7; p = 0.05 in Lithuania) and that people who smoke have less friends (AOR 0.7; p ≤ 0.06) turned out to be less susceptible to tobacco use initiation. In Czech Republic and Slovenia significantly higher susceptibility to tobacco use was observed among females as compared to males (AOR 1.4; p < 0.01), whereas in Romania opposite pattern, although not significant, was observed (p = 0.3). Having more money available for own expenses, positively correlated with smoking suitability in all countries (AOR > 1.5; p < 0.01) except Lithuania where youth with more money available tend to be less susceptible to tobacco use (p > 0.05). Youth who share the opinion that people who smoke have more friends were more susceptible to smoking in Romania (AOR 1.4; p = 0.04) but tend to be less susceptible in other countries. Exposure to advertisements at points of sale was significant correlate of tobacco use susceptibility in Slovakia and Slovenia (AOR 1.4 and 1.5 respectively; p < 0.05), with moderate heterogeneity between the countries. CONCLUSIONS: A high proportion of youth from central and eastern European countries was susceptible to tobacco use. Social factors, and those related to educational and policy issues as well as to attitudes regarding tobacco use were strongly, and consistently across countries, correlated with tobacco use susceptibility. Slight differences in susceptibility to tobacco use between the countries were related to: sex, money available for own expenses, exposure to advertisements at points of sale and opinion that people who smoke have more friends. These factors should be considered when designing and implementing anti-tobacco activities among young people.

Predictors of Counselling Related to a Healthy Lifestyle Carried Out by a General Practitioner.

The aim of the study was to assess whether general practitioners (GPs) monitor and evaluate the health behavior of their patients in the field of a diet, physical activity, and weight control, and whether they provide appropriate counselling as part of this evaluation. Predictors of those activities among physicians were also determined. The cross-sectional study was conducted in the Piotrkowski district among 200 GPs. The questionnaire covered socio-demographic data and lifestyle characteristics of the physicians, their role as healthy lifestyle providers, and whether they assess lifestyle characteristics of their patients and perform healthy lifestyle counselling. More than 60% of the GPs did not evaluate lifestyle features during their patients' examination. In total, 56% of the GPs provided healthy lifestyle recommendations among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations, and 73% of GPs provided recommendations to patients with chronic diseases related to lifestyle. The study showed that the chance to assess lifestyle characteristics of the patients was significantly higher for the GPs who believed that they were obliged to do so (OR = 6.5; p = 0.002). The chance to recommend a healthy lifestyle among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations was 5.9 times higher among the GPs working in the public sector (p < 0.001) and 16.3 times higher for these who believed that they had sufficient knowledge to provide the advice (p = 0.02). The following predictors of providing a healthy lifestyle counselling among patients with diagnosed chronic lifestyle-related diseases were identified: conviction that a GPs is obligated to provide it (OR = 4.4; p = 0.02), sufficient knowledge (OR = 8.7; p = 0.01), and following health recommendations by themselves (OR = 3.9; p = 0.04). Conclusions: The identified predictors are crucial for the development of appropriate strategies aiming at increasing GPs' involvement in preventive measures and consequently at improving the population's health.

Predictors of E-Cigarette Use Susceptibility-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0; p < 0.001; OR = 2.0; p < 0.05; ever users: OR = 2.2; OR = 2.2; p < 0.01), alcohol consumption (never users: moderate drinking OR = 2.9; p < 0.001; binge drinking OR = 2.2; p < 0.01; ever users: moderate drinking OR = 4.2; p < 0.001), cigarette smoking (never users: OR = 14.1; ever users: OR = 11.3; p < 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8; p < 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7; p < 0.01; OR = 2.7; p < 0.05; ever users: OR = 5.4; OR = 4.4; p < 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1; p < 0.001; ever users: OR = 2.9; p < 0.01), and secondary school students (ever users: OR = 5.6; p < 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4; p < 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation.

Perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland.

OBJECTIVES: This study aimed at assessment of the perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. It is hypothesized that different factors can be considered depending on the level of smoking addiction. Therefore, a comparison between light and heavy smokers was performed. MATERIAL AND METHODS: Data collected during the second wave of a cross-sectional study carried out in the Piotrkowski District in October 2016 - February 2017 among 1668 socio-economically disadvantaged persons constituted the source of information for the present study. Barriers and motivators to smoking cessation among daily smokers were identified via face-to face interviews. RESULTS: About one-third of the studied population admitted to being current daily smokers, almost 75% of whom were heavy smokers. The most common barriers to quitting smoking were related to difficulties in quitting (62%), the lack of willingness to quit (56%), as well as addiction and withdrawal symptoms (craving cigarettes [65%], habit [56%], stress and mood swings [55%]). A significantly higher proportion of such barriers was noted among heavy smokers compared to light smokers (p < 0.05). The following motivations to quit were pointed out by the respondents: available pharmacotherapy (47%), access to a free-of-charge cessation clinic (40%), and encouragement and support provided by their doctor (30%), with no differences between various levels of smoking addiction (p > 0.05). CONCLUSIONS: Developing effective interventions targeted at unique deprived populations requires understanding the barriers and motivators to quitting smoking. Social support and financial issues, including free-of-charge pharmacotherapy and cessation clinics, as well as doctor's encouragement and support, are crucial for successful smoking cessation in this vulnerable population. Int J Occup Med Environ Health. 2019;32(3):363-77.

Determinants of phthalate exposure and risk assessment in children from Poland.

Phthalates are a group of widely used chemicals and humans are exposed to them in their daily life. Some phthalates may affect the hormonal balance in both children and adults. The aim of this study was to assess the phthalate exposure and its determinants among children at age of 7 years from the Polish Mother and Child Cohort Study (REPRO_PL). 250 urine samples collected in 2014-2015 were analysed for 21 metabolites of 11 parent phthalates using on-line high performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). This represents the most extensive set of phthalate metabolites ever determined for Poland. Ten metabolites were quantifiable in 100% of the samples, another eight in >90%. The highest median concentrations were found for the primary monoester metabolites of di-iso-butyl (MiBP, 72.4 µg/l), di-n-butyl (MnBP, 56.3 µg/l) and diethyl (MEP, 42.0 µg/l) phthalate, followed by the sum of di-2-ethylhexyl (ΣDEHP, 89.3 µg/l) and di-iso-nonyl (ΣDiNP, 21.9 µg/l) phthalate metabolites. Metabolite concentrations were higher in children at 7 years than in the same children at age 2 or in their mothers during pregnancy. Generally, phthalate exposures in this study were much higher than exposures reported in other European populations. Multivariate regression models showed that body mass index, place of residence, breastfeeding duration, socio-economic status and parental education were associated with the metabolite levels in the 7-year old children. Daily intake and hazard index calculations revealed that a small percentage of children (around 3-10%) exceeded the tolerable daily intakes established by international institutions such as EFSA and U.S. EPA indicating that these children might be at risk of anti-androgenic effects from the individual and cumulative exposure to phthalates. Thus, further monitoring of this population, by educational programs and follow-up interventions, is required.

Sociodemographic, Lifestyle, Environmental and Pregnancy-Related Determinants of Dietary Patterns during Pregnancy.

Background: Characterization of dietary patterns represents a valid and meaningful measure of overall diet quality and nutrient intake. The study aims at evaluating the sociodemographic, lifestyle, environmental, and pregnancy-related determinants of maternal dietary patterns during pregnancy. Methods: The analysis was conducted on a group of pregnant women from the Polish Mother and Child Cohort (REPRO_PL). During the second trimester of pregnancy, 1306 women filled in a modified version of the validated food frequency questionnaire (FFQ). Dietary patterns were estimated using an exploratory factor analysis. Potential dietary determinants were assessed via a questionnaire or biomarker measurements (saliva cotinine level). Results: Two dietary patterns were identified. The Prudent dietary pattern was characterized by high consumption of fruit, vegetables, legumes, whole grains, poultry, and low-fat dairy products, while the Western dietary pattern included high intake of refined grains, processed meat, potatoes, and very low intake of whole grains. Clear sociodemographic, environmental, lifestyle, and pregnancy-related determinants of diet quality were established. Older age (ß = 0.2; p < 0.01), higher educational level (ß = 0.3; p < 0.01), and socioeconomic status (SES) (ß = 0.2; p < 0.01), overweight/obesity before (ß = 0.3; p < 0.01), as well as physical activity during pregnancy (ß = 0.2; p = 0.01) were positive determinants of a healthier diet (increasing Prudent⁻Western difference in dietary pattern scores). On the other hand, parity (ß = -0.2; p = 0.04) and living in small cities (ß = -0.3; p = 0.02) were significantly related to a rather Western dietary pattern. Conclusions: The current study presents evidence on specific factors influencing dietary patterns. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations during pregnancy.

Involuntary Smoking in Adolescents, Their Awareness of Its Harmfulness, and Attitudes towards Smoking in the Presence of Non-Smokers.

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles (p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned (p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people.

How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes (p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers (p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

Perceived Relative Harm of Selected Cigarettes and Non-Cigarette Tobacco Products-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13-19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.

Use of electronic cigarettes among secondary and high school students from a socially disadvantaged rural area in Poland.

BACKGROUND: The use of e-cigarettes has been growing and has become a significant public health concern. Prevention of the youth access to, initiation and continuous use of e-cigarettes with special attention to vulnerable groups is a subject of a health debate. However, still little is known about characteristics of the underage e-cigarette users from different geographic and socio-economic backgrounds as well as other potential factors associated with the use of e-cigarettes, including simultaneous use with tobacco products or alcohol. The aim of the study was to investigate the prevalence and factors associated with ever and continued e-cigarette use among the secondary and high school students from a socially disadvantaged rural area in Poland. METHODS: The study sample consisted of 3552 students aged 13-19 years from Piotrkowski district. The anonymous, self-administered questionnaire adapted from the Global Youth Tobacco Survey was implemented to collect relevant information. The uni- and multivariate logistic regression analyses were applied to identify factors associated with ever, current (in the previous 30 days) and continued e-cigarette use. RESULTS: Almost 22 % of the sample reported ever e-cigarettes use and 27 % of the respondents indicated e-cigarettes use in the past month. Boys, in comparison with girls, were more likely to report current e-cigarette use (OR = 1.7; p < 0.001). Current e-cigarette use was strongly associated with alcohol consumption (OR = 4.3; p < 0.001), current (OR = 32.5; p < 0.001) and ever tobacco smoking (OR = 7.5; p < 0.001) as well as smoking parents (OR = 1.4; p < 0.05) and friends (OR = 4.5; p < 0.05). The use of e-cigarettes was also significantly associated with harm perception (p < 0.001). A similar pattern was observed among ever e-cigarette users. Male gender (OR = 1.4; p < 0.05), current tobacco smoking (OR = 3.0; p < 0.01) and lack of knowledge about a ban on smoking in the school (OR = 1.4; p < 0.05) were predictors of the continued e-cigarette use. Higher paternal education (OR = 0.5; p < 0.001) and perception of e-cigarettes as more harmful comparing to tobacco (OR = 0.2; p < 0.001) protected from the continued e-cigarette use. CONCLUSIONS: E-cigarette use is widespread in the investigated population, especially among boys, those with other risky behaviors and with smoking parents or friends. There is a need for further research and preventive policies to protect the youth from that exposure.

Predictors of environmental lead exposure among pregnant women - a prospective cohort study in Poland.

Blood lead levels (BLL) in women of child-bearing age have been decreasing in recent decades, but still remains a concern for long-term effects of child psychomotor development. The aim of the study was to characterize lead exposure among Polish pregnant women and assess the relationship between BLL and selected socio-demographic, economic and lifestyle factors. The study population consisted of 594 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort Study (REPRO_PL). The women were interviewed three times during pregnancy (once in each trimester. Lead concentration in the blood collected during the second trimester of pregnancy was analyzed using graphite furnace atomic absorption spectrometry (GF-AAS), or inductively coupled plasma mass spectrometry (ICP-MS). Active and passive smoking was analyzed by the cotinine level in saliva using liquid chromatography with tandem mass spectrometry (LC-MS/MS). The lead level in the blood ranged from 0.3 - 5.7 µg/dL, with a geometric mean (GM) of 1.1 µg/dL (GSD ±0.2 µg/dL). Statistically significant associations were found between BLL and factors such as maternal age (ß=0.01; p=0.02), education (ß=0.08; p=0.04) and prepregnancy BMI (ß=0.1; p=0.001). Additionally, BLL increased with increasing cotinine level in saliva (ß=0.02; p=0.06) and decreased with the increasing distance from the copper smelter (ß=-0.1; p=0.009). Public health interventions, especially in regions with a higher level of exposure to lead, among women with lower SES and among smokers, are still reasonable.

Comprehensive tobacco control measures--the overview of the strategies recommended by WHO.

According to the World Health Organization, there are more than one billion smokers in the world, and tobacco is said to kill half of its users. The European Region of WHO, with only 15% of the world's population, faces nearly one third of the worldwide burden of tobacco related diseases. Millions of lives could be saved with effective and comprehensive tobacco control strategy. In response to this, the World Health Organization has offered a wide range of information and recommendations to governments, organizations, health-care professionals, and tobacco users and non-users worldwide. This paper is focusing on various activities that governments, organizations or even individuals can undertake to help smokers to quit and decrease percentages of tobacco users and save millions of lives.

[Teachers attitudes towards smoke-free regulations]. / Opinie i postawy nauczycieli wobec zakazu palenia w miejscach publicznych.

The aim of the study was to analyze the teachers attitudes towards smoke-free regulations in public places. The study population consisted of 348 teachers. Among the study participants the questionnaire was conducted including socio-demographic characteristic and smoking profile. Detailed information was collected about teachers' opinion on smoke-free public places. About 13% of study participants declared current daily tobacco smoking and 5% smoked occasionally. Almost all study participants (90%-93%) are in favor of smoking ban in offices, health and educational buildings and sport facilities. 83% supported smoking ban in workplaces. Most of the teachers were in favor of smoke-free restaurants (71%) but they were less likely to support smoke-free bars, pubs and clubs (55%). The percentage of teachers who supported total ban on smoking in the presence of pregnant women was 94% and in the presence of children 93%. About 27%of the study subjects did not accept the concept of raising taxes on tobacco. Total ban on tobacco advertising was accepted by 70% of teachers and support for pictorial warning on tobacco packages declared 75% of participants. About 45% of study population indicated that they noted other teachers smoked at school (where smoking is banned). For students such percentages were even higher (76%). It is important to strengthen educational and informational activities to increase public awareness on health consequences of active and passive smoking and the ways of elimination of such exposures.

Changes in smoking prevalence and exposure to environmental tobacco smoke among adults in Lódz, Poland.

UNLABELLED: Comprehensive monitoring informs the stakeholders about the level of tobacco epidemic and helps to allocate tobacco control resources where they are most needed and will be most effective. The aim of the paper was to evaluate the prevalence of daily cigarette smoking and environmental tobacco smoke (ETS) exposure among adult citizens of Lódz area in Poland between year 2001 and 2010 by selected characteristics. MATERIAL AND METHODS: For the purpose of the presented analysis, data were used from 3 cross-sectional studies on randomly-selected 3,874 adults from the Lódz area, conducted in 2001, 2005 and 2010. Changes in the rates between the surveys were assessed by odds ratio. RESULTS: Smoking prevalence remained stable but high between 2001-2010. There was an inverse relationship between smoking prevalence and educational level for both genders (p for trend ≤0.01) in each survey. For men in all surveys, the prevalence of current daily tobacco smoking decreased with increased income (p for trend ≤0.01), and also for women in the 2009-2010 survey (p for trend =0.03). The statistically significant changes for the comparison of 2001 and 2005 surveys were observed for exposure to ETS (p<0.001). Percentages of men and women who declared exposure to environmental tobacco smoke at least one hour per day decreased significantly. Furthermore, the proportion of people who declared exposure to ETS decreased with the increasing age of participants (p for trend ≤0.005), level of education for men in both surveys, and for women in the 2001 survey (p for trend ≤0.003), and income for both men and women in the 2001 survey (p for trend <0.001). CONCLUSION: Established, long-term tobacco surveillance systems of smoking and ETS exposure, based on nationally and locally representative samples, are necessary in Poland.

Tobacco advertisements targeted on women: creating an awareness among women.

It has been always believed that men smoke more than women, but the trend of smoking in women is increasing nowadays. In some countries there are even more female smokers than male smokers. This is a major health risk because women are present and future mothers, and increasing number of smoking women will enlarge the number of exposed children. Relatively few women are aware of gender-specific health risks, including cervical cancer, osteoporosis, poor pregnancy outcome and early menopause. Tobacco related diseases are on the rise in women, considering the fact that more women now die of lung cancer than breast cancer. Tobacco companies have invented various ways to target women through tobacco advertising despite the various bans. This inevitably leads to the increase in female smoking rates. There are various recommendations from the World Health Organization which include the need for governments to pay particular attention to protect women from the tobacco companies' attempts to lure them into lifetimes of nicotine dependence and to take up counter advertisements against the tobacco companies.

[Tobacco smoking and other negative lifestyle behaviors among economically active individuals]. / Palenie tytoniu i inne negatywne zachowania zdrowotne wsród osób czynnych zawodowo.

BACKGROUND: Tobacco smoking, lack of recreational physical activity, unbalanced diet, overweight and obesity are the major modifiable risk factors for chronic diseases. The aim of the study was to evaluate the prevalence of smoking and the other lifestyle behaviors among economically active adults. MATERIAL AND METHODS: The study population consisted of 442 randomly selected economically active adults from the Lódz and Lublin districts, Poland. The prevalence and different possible combination of four major risk factors for chronic diseases was determined. RESULTS: About 40% of men and 28% of women smoke at least one cigarette per day. Only 3.5% of men and 1.9% of women meet the recommended guidelines for four common health life style factors. Only about 2% of smokers obey the rules relating to other healthy behaviors. In women smoking cigarettes, the risk for not being physically active is twice as high as that in nonsmokers. CONCLUSIONS: The prophylactic programs for healthy lifestyle behaviors should be addressed to all economically active individuals, taking into account their level of education, the type of work performed and income.

[Smoke-free environment--nurse attitudes towards smoke-free regulations]. / Tworzenie srodowiska wolnego od dymu tytoniowego--postawy pielegniarek wobec zakazu palenia papierosów w miejscach publicznych.

The aim of the study was to analyze the nurse attitudes towards smoke-free regulations in public places. The study population consisted of 299 nurses. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and ETS profile, knowledge about health effects of smoking and abilities for conduction of antismoking counseling. Detail information was collected about nurse opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 18% of study participants declared current tobacco smoking and 25% were former smokers. Almost all participating in the study women (85%-98%) are in favor of smoking ban in offices, health and educational buildings. 75% supported smoking ban in workplaces but 15% of them were somewhat opposed. Most of the nurses were in favor of smoke-free restaurants (64%) but they were less likely to support smoke-free bars, pubs and clubs (45%). Unfortunately 63% of interview women do not accept smoking ban in private cars. The percentage of women who support total ban of smoking in the presence of pregnant women was 93% and in the presence of children 79%. It is important to conduct educational and informational activities to increase public awareness on health consequences of active and passive smoking and the ways of elimination of such exposures.

[Risk factors for smoking among the adult population--results of WOBASZ study in Lódz district]. / Czynniki warunkujace palenie tytoniu wsród osób doroslych--wyniki badania WOBASZ w województwie lódzkim.

INTRODUCTION: Nowadays, tobacco smoking is the single most preventable cause of death all over the word. Now it kills annually more than five million people and this number will increase to over 8 million by 2030. The aim of this study was to assess the prevalence of smoking and risk factors for smoking in the adult population of the Lódz district. MATERIAL AND METHODS: We included into the study a representative group of the adult population (1037 people) living in this district. The sampling and all study procedures were based on the methods for Multi-Center Representative Nationwide Study--WOBASZ. A questionnaire was employed to determine the smoking status. Logistic regression models were applied to assess the factors related to the smoking habit. RESULTS: In the study population, 40.8% of men and 19.5% of women were active smokers. The following factors were associated with the smoking status: lower educational level (OR = 3.1; 95% CI: 1.4-6.8) and lower level of income (OR = 2.4; 95% CI: 1.2-4.9) in men, and marital status--widow (OR = 3.3, 95% CI: 1.4-7.5) in women. People living in small districts showed a higher risk for smoking than those living in larger urban areas (men, OR = 2.1; 95% CI: 1.3-3.6; women, OR = 2.8, 95% CI: 1.5-5.2) Older persons smoke less frequently than younger ones (men, OR = 0.3; 95% CI: 0.1-0.8; women, OR = 0.1; 95% CI: 0.02-0.5). CONCLUSIONS: The lower levels of education and income, as well as living in small districts are the risk factors for cigarette smoking.

Smoking predictors among economically active individuals.

OBJECTIVES: The study objective was to evaluate an association between selected work-related and socio-economic factors and tobacco smoking among economically active individuals. MATERIALS AND METHODS: The study was conducted among randomly selected residents of the city of Lódz (n = 598) aged 25-64 years. The smoking status was determined based on questionnaire data. Logistic regression models were applied to assess the factors related to the smoking habit. RESULTS: Multifactorial logistic regression analysis indicated that low level of education, lack of recreational physical activity and medium/heavy physical work were significant determinants of smoking. CONCLUSIONS: Prevention programs aimed at improving health-related habits and behaviors should be addressed to all economically active individuals, particularly to those who perform medium and heavy physical work. An antismoking intervention should be tailored to individual needs, taking into account the educational level.

Reducing health risks arising from child and adolescent labor.

OBJECTIVES: The aim of the studywas to work out a program that would help develop the most effective methods for protecting the safety and health of young workers. MATERIALS AND METHODS: The program was designed by a multidisciplinary team of experts in occupational and public health, occupational hygiene, health promotion, sociology, and regulatory and control activities. RESULTS: The program points out the major aspects to be considered while implementing the existing legislation. The employers should have a proper recognition of health hazards related to working conditions at their enterprises. These should be considered while assessing work capability of adolescents during the pre-placement and periodic medical examinations. Prophylactic examinations for adolescent workers should be oriented towards the potential or existing health hazards and strenuous conditions of in-plant vocational training. It is essential to inform them about work-related health hazards and the preventive methods to be applied by both the workers themselves and the occupational health services. If a health problem or ailment is detected by an occupational physician, the adolescent worker should be referred to primary health care unit for further diagnostics. CONCLUSIONS: The most effective ways to protect the safety and health of young workers include a more accurate assessment of working conditions, contracting prophylactic examinations with only one occupational health service unit, providing appropriate risk information to adolescent workers/students, and a closer collaboration between school administration, employers and occupational health services..